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1.
Geophys J Int ; 229(3): 1914-1926, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35250356

RESUMO

Here we qualitatively analyse the mass change patterns across Antarctica via independent component analysis (ICA), a statistics-based blind source separation method to extract signals from complex data sets, in an attempt to reduce uncertainties in the glacial isostatic adjustment (GIA) effects and improve understanding of Antarctic Ice Sheet (AIS) mass-balance. We extract the six leading independent components from gravimetric data acquired during the Gravity Recovery and Climate Experiment (GRACE) and GRACE Follow-On (GRACE-FO) missions. The results reveal that the observed continental-scale mass changes can be effectively separated into several spatial patterns that may be dominated by different physical processes. Although the hidden independent physical processes cannot be completely isolated, some significant signals, such as glacier melt, snow accumulation, periodic climatic signals, and GIA effects, can be determined without introducing any external information. We also observe that the time period of the analysed data set has a direct impact on the ICA results, as the impacts of extreme events, such as the anomalously large snowfall events in the late 2000s, may cause dramatic spatial and temporal changes in the ICA results. ICA provides a unique and informative approach to obtain a better understanding of both AIS-scale mass changes and specific regional-scale spatiotemporal signal variations.

2.
Hepatology ; 58(1): 264-72, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23408380

RESUMO

UNLABELLED: The biochemical response to ursodeoxycholic acid (UDCA) in primary biliary cirrhosis is a strong predictor of long-term outcome and thus facilitates the rapid identification of patients needing new therapeutic approaches. Numerous criteria for predicting outcome of treatment have been studied based on biochemical response to UDCA at 1 year. We sought to determine whether an earlier biochemical response at 3 or 6 months could as efficiently identify patients at risk of poor outcome, as defined by liver-related death, liver transplantation, and complications of cirrhosis. We analyzed the prospectively collected data of 187 patients with a median follow-up of 5.8 years (range, 1.3-14 years). The survival rates without adverse outcome at 5 years and 10 years were 86% and 63%. Under UDCA therapy, laboratory liver parameters experienced the most prominent improvement in the first 3 months (P < 0.0001) and then stayed relatively stable for the following months. The Paris, Barcelona, Toronto, and Ehime definitions, but not the Rotterdam definition, applied at 3, 6, and 12 months significantly discriminated the patients in terms of long-term outcome. Compared with biochemical responses evaluated after 1 year of UDCA therapy, biochemical responses at the third month demonstrated higher positive predictive value (PPV) but lower negative predictive value (NPV) and increased negative likelihood ratio (NLR) by all definitions; biochemical responses at the sixth month showed higher or the same PPV and NPV and lower NLR by all definitions. CONCLUSION: For the previously published criteria, biochemical responses at the sixth month can be used in place of those evaluated after 1 year of UDCA therapy. Our findings justify a more rapid identification of patients who need new therapeutic approaches.


Assuntos
Cirrose Hepática Biliar/tratamento farmacológico , Cirrose Hepática Biliar/metabolismo , Ácido Ursodesoxicólico/uso terapêutico , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico
3.
Immun Inflamm Dis ; 12(4): e1243, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38577988

RESUMO

OBJECTIVE: To explore the role of interleukin (IL)-17 in connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) and to investigate its possible mechanism on pulmonary artery smooth muscle cells (PASMCs). METHODS: Enzyme-linked immunosorbent assay (ELISA) were used to compare levels of serum IL-17 in patients with CTD-PAH and healthy controls (HCs). After treatment for 3 months, the serum IL-17 levels were tested in CTD-PAH. ELISA and immunohistochemistry were used to compare levels of serum IL-17 and numbers of pulmonary artery IL-17+ cells, respectively, in a rat model of monocrotaline-induced PAH and untreated rats. Proliferation, migration, and inflammatory factors expression of PASMCs were assessed after stimulation with different concentrations of IL-17 for various time periods. Proteins in the mitogen-activated protein kinase (MAPK) pathway were examined by western blot. RESULTS: Levels of IL-17 were upregulated in patients with CTD-PAH compared to HCs. After 3 months of treatment, serum IL-17 levels were downregulated with pulmonary artery pressure amelioration. Moreover, serum IL-17 levels and numbers of IL-17+ cells infiltrating lung arterioles were increased in PAH model rats. IL-17 could dose- and time-dependently promote proliferation and migration of PASMCs as well as time-dependently induce IL-6 and intercellular cell adhesion molecule-1 (ICAM-1) expression. The levels of MKK6 increased after IL-17 treatment. Inhibition of MAPK decreased proliferation of PASMCs. CONCLUSION: Levels of IL-17 may increase in CTD-PAH, and IL-17 promotes proliferation, migration, and secretion of IL-6 and ICAM in PASMCs, respectively, which likely involves the p-38 MAPK pathway.


Assuntos
Interleucina-17 , Miócitos de Músculo Liso , Hipertensão Arterial Pulmonar , Animais , Humanos , Ratos , Proliferação de Células , Interleucina-17/metabolismo , Interleucina-17/farmacologia , Interleucina-6/metabolismo , Hipertensão Arterial Pulmonar/induzido quimicamente , Hipertensão Arterial Pulmonar/metabolismo , Artéria Pulmonar/metabolismo
4.
Clin Exp Med ; 22(2): 277-283, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34191227

RESUMO

To describe the clinical manifestations, immunological features, and risk factors in patients with sarcoidosis complicated with autoimmune diseases (ADs) as well as determine the frequency of autoantibodies and possible correlation between autoantibodies and laboratory data. Patients with pathologically confirmed sarcoidosis at Beijing Chaoyang Hospital (China) between January 2017 and October 2020 were included. Age- and sex-matched patients who visited the rheumatology outpatient clinic without systemic or ADs were included as controls. Demographic, clinical, serological, and radiological data of sarcoidosis patients were recorded and analyzed. To exclude ADs, autoantibodies, such as antinuclear antibody, extractable nuclear antigen antibodies, and anti-cyclic citrullinated peptide antibody were assessed in controls. A total of 154 sarcoidosis patients (111 females; 72.1%) with a mean ± standard deviation age of 50.7 ± 10.3 years were included. Nineteen patients (12.3%) had ADs; Hashimoto's thyroiditis (n = 6) and Sjogren's syndrome (n = 4) were common. Age, globulin, immunoglobulin G, erythrocyte sedimentation rate (ESR), and C-reactive protein were significantly different between sarcoidosis patients with and without ADs. The ESR level might be a risk factor for sarcoidosis complicated with ADs (RR = 1.053; P = 0.018). Autoantibodies were detected in 29 patients (18.8%), and the frequency was significantly higher than that in controls (18.8% vs. 3%; P = 0.001). Sarcoidosis patients were more likely to have autoantibodies despite the absence of ADs (10.4% vs. 3%; P = 0.031). Age may be a risk factor for sarcoidosis patients presenting with autoantibodies (RR = 1.077; P = 0.042). An association was identified between ADs and sarcoidosis. The inflammatory indexes, such as ESR, IgG, and CRP, were significantly different between sarcoidosis patients with and without ADs. ESR might be a risk factor for the coexistence of ADs and sarcoidosis. Sarcoidosis patients were prone to being autoantibody-positive despite the absence of ADs, and age might be a risk factor for sarcoidosis presenting with autoantibodies.


Assuntos
Doenças Autoimunes , Sarcoidose , Síndrome de Sjogren , Adulto , Anticorpos Antinucleares , Autoanticorpos , Doenças Autoimunes/complicações , Proteína C-Reativa , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoidose/complicações
5.
J Thorac Dis ; 11(4): 1580-1588, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31179102

RESUMO

BACKGROUND: To describe the clinical manifestations, immunological features, treatments, and outcomes of patients with thymic epithelial tumor (TET) complicated by immunological abnormalities, and to improve knowledge on immunological abnormalities in this rare disease. METHODS: Patients with pathologically confirmed TET at Beijing Chaoyang Hospital between January 2013 and May 2018 were included in this study, and clinical data were analyzed retrospectively. Immunological abnormalities were classified into two groups as follows: Good syndrome (GS) and autoimmune disease (AD). RESULTS: Fifty-nine TET patients were enrolled; twenty-two patients (37.3%) had immune dysfunction. There were no gender, age, or histological type differences between groups with or without immunological abnormalities. Six patients had GS, of whom four patients were diagnosed after thymectomy. Recurrent respiratory infections, particularly opportunistic infections, were the most common manifestation. Three GS patients developed a second cancer (50%; P=0.011). Anti-infective therapy and immunoglobulin supplements effectively treated GS. Seventeen patients developed ADs, including myasthenia gravis (MG) (n=13), Hashimoto's thyroiditis (n=4), Sjogren's syndrome (n=1), rheumatoid arthritis (n=1), pemphigus (n=1), and Evans syndrome (n=1). One patient developed both MG and GS and 4 patients presented with two ADs. Three AD cases occurred after thymectomy. Pemphigus and 80% (8/10) of MG cases were resolved following thymectomy. CONCLUSIONS: There is a strong association between immunological abnormalities and TET, which may present at any time point during the disease, even after thymectomy. In addition to infection, GS patients are more likely to develop a second cancer. Thymectomy may produce favorable outcomes for MG in this study, while surgery does not improve immunodeficiency in GS patients.

6.
Clin Rheumatol ; 37(1): 271-275, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28785856

RESUMO

Patients with systemic lupus erythematosus (SLE) have a high risk of infection. Central nervous system infection and neuropsychiatric SLE are both major causes of death. It is vital to distinguish between these two conditions to improve prognosis due to the treatment paradigms required for each condition. Here, we report one case of meningoencephalitis by Listeria monocytogenes (LM) in a patient with SLE who presented with fever and developed headache and altered in consciousness in the hospital. The cerebrospinal fluid culture was positive for LM, and magnetic resonance imaging (MRI) findings were suggestive of ependymitis and periventricular white matter lesions. Amoxicillin/sulbactam, trimethoprim-sulfamethoxazole, and rifampicin were administered for 8 weeks. The patient had a relative good recovery without serious neurological sequelae after a follow-up of nearly 2 years. MRI abnormalities also had obvious resolution.


Assuntos
Listeriose/complicações , Lúpus Eritematoso Sistêmico/complicações , Meningoencefalite/complicações , Adulto , Feminino , Humanos , Listeria monocytogenes/isolamento & purificação
7.
Oxid Med Cell Longev ; 2017: 7584691, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29213353

RESUMO

Resveratrol (RSV) is used as a protective therapy against diabetic retinopathy. However, the mechanism(s) underlying this protective effect has not been fully elucidated. Bovine retinal capillary endothelial cells (BRECs), an in vitro model, were used to investigate the mechanism of RSV. Our results showed that high glucose induced significant cellular apoptosis in BRECs, which was accompanied by increased intracellular levels of reactive oxygen species (ROS) and cleaved caspase-3. The glucose-induced apoptosis and ROS elevation were both inhibited by RSV. High glucose was found to decrease the levels of phosphorylated AMP-activated protein kinase (p-AMPK), which was accompanied by increased levels of Sirt1 and PGC-1α. These changes were reversed by RSV. We also demonstrated that AMPK regulates the modulations of Sirt1 and PGC-1α using specific inhibitors of AMPK and Sirt1 and small interfering RNAs of PGC-1α. In summary, the current study demonstrates that RSV is effective against high glucose-induced cellular apoptosis and its action is exerted via the inhibition of ROS/AMPK/Sirt1/PGC-1α pathway.


Assuntos
Apoptose/efeitos dos fármacos , Glucose/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Estilbenos/farmacologia , Proteínas Quinases Ativadas por AMP/genética , Proteínas Quinases Ativadas por AMP/metabolismo , Animais , Caspase 3/metabolismo , Bovinos , Células Cultivadas , Células Endoteliais/citologia , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/antagonistas & inibidores , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/genética , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Fosforilação , Interferência de RNA , RNA Interferente Pequeno/metabolismo , Resveratrol , Sirtuína 1/genética , Sirtuína 1/metabolismo , Estilbenos/farmacocinética
8.
Clin Rheumatol ; 34(5): 915-20, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25064131

RESUMO

The objective of this study was to investigate the therapeutic effect of a tumor necrosis factor-alpha (TNF-α) antagonist on the sexual quality of life of male patients with ankylosing spondylitis (AS). In this open-label study, 42 AS patients were grouped into the TNF-α antagonist treatment group and the non-TNF-α antagonist treatment group for 3 months. Clinical and laboratory indices and changes in the sexual quality of life were compared to assess the efficacy of TNF-α antagonists on sexual activity. The relationship between sexual quality and disease activity was analyzed. There were no significant differences in baseline data between the two groups. After treatment, disease activity and quality of life were improved in these two groups. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (1.9 ± 1.6 vs. 3.0 ± 1.3, p = 0.020), erythrocyte sedimentation rate (ESR) (9 ± 7 mm/1 h vs. 18 ± 17 mm/1 h, p = 0.031), and C-reactive protein (CRP) levels (1.8 ± 2.1 mg/dl vs. 6.2 ± 8.5 mg/dl, p = 0.035) were significantly lower in the TNF-α antagonist treatment group than in the non-TNF-α antagonist treatment group. The extent of improvement in the quality of life was more evident in the TNF-α antagonist treatment group. The average degree of improvement in the quality of life was negatively related to the BASDAI score and the Bath Ankylosing Spondylitis Functional Index score in the TNF-α antagonist treatment group (r = -0.497, p = 0.018; r = -0.558, p = 0.007, respectively). Sexual quality of life and disease activity are improved after treatment with TNF-α antagonists in male patients with AS. The extent of improvement in sexual quality and disease activity are positively related.


Assuntos
Antirreumáticos/uso terapêutico , Etanercepte/uso terapêutico , Infliximab/uso terapêutico , Qualidade de Vida , Comportamento Sexual , Espondilite Anquilosante/tratamento farmacológico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Sedimentação Sanguínea , Proteína C-Reativa/imunologia , Humanos , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Espondilite Anquilosante/imunologia , Sulfassalazina/uso terapêutico , Resultado do Tratamento , Adulto Jovem
9.
Medicine (Baltimore) ; 94(44): e1888, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26554784

RESUMO

T helper (Th) 17 cells were reported to have the property of proinflammation and profibrosis. We first investigate the levels of Th17 cells in primary biliary cirrhosis (PBC) patients, and then explore their distribution and fibrotic role in the disease.We compared the circulating Th17 and hepatic interleukin (IL)-17-positive cells between patients and healthy controls (HCs) at different disease stages by flow cytometry and immunohistochemistry, respectively. The levels of chemokine (c-c motif) ligand (CCL) 20 were then measured. For exploration of the reason why Th17 cells increased, CD4CD161 populations were sorted and cultured with IL-23 and IL-1ß to analyze their proliferation and IL-17 secretions. The serum IL-23 and IL-1ß were tested by enzyme-linked immunosorbent assay. The proliferation and expressions of α-smooth muscle actin and IL-8 of hepatic stellate cells (HSCs) were identified after stimulated by different concentrations of IL-17.Circulating and hepatic Th17 cells were elevated in PBC patients compared with HCs. Early PBC patients presented with more Th17 cells in periphery blood and less in the liver than advanced PBC patients. Accordingly, the levels of both serum and hepatic CCL20 for Th17 cells were higher, especially in those with advanced disease. The progenitor of Th17, CD4CD161 cell was increased in PBC. Moreover, the percentage of Th17 cells was positively related with CD4CD161 cell. After stimulation with IL-23 and IL-1ß which were improved in PBC patients, CD4CD161 cells from PBC patients expressed more IL-17, although their proliferation were not different between 2 groups. IL-17 can promote the proliferation of HSCs at a dose-dependent method, and also increase the IL-8 expression in a dose/time-dependent way. Anti-IL-17 can neutralize the above reactions.CD4CD161 cells are a source of increased Th17 in PBC patients. With disease progression, Th17 population decreased in the circulation, accompanied by greater accumulation in the liver, which is regulated by CCL20 in advanced patients. IL-17 may be involved in the process of PBC fibrosis.


Assuntos
Imunidade Celular , Interleucina-17/metabolismo , Cirrose Hepática Biliar/imunologia , Fígado/metabolismo , Células Th17/imunologia , Adulto , Células Cultivadas , Progressão da Doença , Ensaio de Imunoadsorção Enzimática , Feminino , Citometria de Fluxo , Humanos , Imuno-Histoquímica , Fígado/imunologia , Fígado/patologia , Cirrose Hepática Biliar/metabolismo , Masculino , Células Th17/metabolismo
10.
J Ocul Pharmacol Ther ; 31(9): 555-62, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26207889

RESUMO

PURPOSE: To determine whether curcumin offers neuroprotection to minimize the apoptosis of neural cells in the retina of diabetic rats. METHODS: Streptozotocin (STZ)-induced diabetic rats and control rats were used in this study. A subgroup of STZ-induced diabetic rats were treated with curcumin for 12 weeks. Retinal histology, apoptosis of neural cells in the retina, electroretinograms, and retinal glutamate content were evaluated after 12 weeks. Retinal levels of Ca(2+)/calmodulin-dependent protein kinase II (CaMKII), phospho-CaMKII (p-CaMKII), and cleaved caspase-3 were determined by Western blot analysis. RESULTS: The amplitudes a-wave, b-wave, and oscillatory potential were reduced by diabetes, but curcumin treatment suppressed this reduction of amplitudes. Curcumin also prevented cell loss from the outer nuclear, inner nuclear, and ganglion cell layers. Apoptosis of retinal neurons was detected in diabetic rats. The concentration of glutamate in the retina was higher in diabetic rats, but was significantly reduced in the curcumin-treated group. Furthermore, p-CaMKII and cleaved caspase-3 expression were upregulated in the diabetic retina, but reduced in curcumin-treated rats. CONCLUSIONS: Curcumin attenuated diabetes-induced apoptosis in retinal neurons by reducing the glutamate level and downregulating CaMKII. Thus, curcumin might be used to prevent neuronal damage in the retina of patients with diabetes mellitus.


Assuntos
Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/metabolismo , Curcumina/farmacologia , Diabetes Mellitus Experimental/tratamento farmacológico , Retina/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Western Blotting , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/genética , Caspase 3/genética , Diabetes Mellitus Experimental/complicações , Regulação para Baixo/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Masculino , Neurônios/efeitos dos fármacos , Neurônios/patologia , Fármacos Neuroprotetores/farmacologia , Ratos , Ratos Sprague-Dawley , Retina/patologia , Estreptozocina , Regulação para Cima/efeitos dos fármacos
11.
World J Gastroenterol ; 19(7): 1111-8, 2013 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-23467321

RESUMO

AIM: To examine the clinical features and analyze prognostic factors in a prospective study of primary biliary cirrhosis (PBC) patients. METHODS: From 1995 to 2010, PBC patients without hepatic decompensation seen at the Peking Union Medical College Hospital were enrolled. Clinical signs and manifestations (pruritus, persistent fatigue, jaundice and pain in the right hypochondrium), laboratory parameters (auto-antibodies for autoimmune hepatic disease, biliary and hepatic enzymes, immunoglobulin, bilirubin, and albumin) and imaging findings were recorded at entry and at specific time points during follow-up. Cox regression and Kaplan-Meier analyses, respectively, assessed the risk factors for hepatic decompensation and survival. RESULTS: Two hundred and sixty-two PBC patients were enrolled with a median follow-up of 75.2 mo (range, 21-201 mo). The 240 patients were aged 51.5 ± 10.2 years at diagnosis and 91.6% were female. Two hundred and forty-five (93.5%) were seropositive for anti-mitochondrial antibodies. At presentation, 170 patients (64.9%) were symptomatic, while 96 patients (36.6%) had extra-hepatic autoimmune disease. During the follow-up period, 62 (23.7%) patients developed hepatic decompensation of whom four underwent liver transplantation and 17 died. The cumulative survival rate and median survival time were 83.9% and 181.7 mo, respectively. Cox regression analysis revealed that an incomplete ursodeoxycholic acid (UDCA) response or inconsistent treatment [P < 0.001; hazard risk (HR) 95%CI = 2.423-7.541], anti-centromere antibodies (ACA) positivity (P < 0.001; HR 95%CI = 2.516-7.137), alanine aminotransferase ratio (AAR) elevations (P < 0.001; HR 95%CI = 1.357-2.678), and histological advanced liver disease (P = 0.006; HR 95%CI = 1.481-10.847) were predictors of hepatic decompensation. The clinical features and survival of PBC in China are consistent with those described in Western countries. CONCLUSION: Incomplete UDCA response or inconsistent treatment, ACA positivity, AAR elevations, and advanced histological stage are predictors of decompensation.


Assuntos
Cirrose Hepática Biliar/complicações , Falência Hepática/etiologia , Adulto , Biomarcadores/sangue , Distribuição de Qui-Quadrado , China , Colagogos e Coleréticos/uso terapêutico , Progressão da Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Cirrose Hepática Biliar/sangue , Cirrose Hepática Biliar/diagnóstico , Cirrose Hepática Biliar/imunologia , Cirrose Hepática Biliar/mortalidade , Cirrose Hepática Biliar/terapia , Falência Hepática/sangue , Falência Hepática/diagnóstico , Falência Hepática/imunologia , Falência Hepática/mortalidade , Falência Hepática/terapia , Transplante de Fígado/efeitos adversos , Transplante de Fígado/mortalidade , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Ácido Ursodesoxicólico/uso terapêutico
12.
World J Gastroenterol ; 18(48): 7141-8, 2012 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-23326118

RESUMO

Primary biliary cirrhosis (PBC) is an autoimmune liver disease characterized by the presence of serum autoantibodies and chronic nonsuppurative destructive cholangitis. The pathogenesis of PBC involves environmental factors, genetic predisposition and loss of immune tolerance. In recent years, it has become univocally accepted that an inappropriately activated immune response is one of the most important factors in PBC. In this study, the role of autoimmunity in PBC is summarized and a feasible research orientation is recommended.


Assuntos
Autoimunidade , Cirrose Hepática Biliar/imunologia , Animais , Autoanticorpos/imunologia , Linfócitos B/citologia , Linfócitos T CD4-Positivos/citologia , Quimiocinas/metabolismo , Modelos Animais de Doenças , Feminino , Humanos , Imunidade Celular , Imunidade Humoral , Imunidade Inata , Imunoglobulina M/imunologia , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Células Matadoras Naturais/citologia , Cirrose Hepática Biliar/terapia , Camundongos , Ácido Ursodesoxicólico/uso terapêutico
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